Menino battles Crohns disease

Doctors say illness no bar to office

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Doctors for Mayor Thomas M. Menino confirmed for the first time yesterday that he has Crohn's disease, a chronic intestinal condition, following his third admission to the hospital for abdominal pain since he took office.

His doctors, at a press conference at Brigham and Women's Hospital, said the mayor will have to take anti-inflammatory medication for the rest of his life, but said he can continue to fully function and carry out the demands and duties of his office.

His most recent intestinal flareup occurred after he ate peanuts and Cracker Jacks at a Red Sox game on Monday night. Hard-to-digest foods such as nuts, seeds, and corn are normally off-limits to Crohn's sufferers.

''It's very normal for people with a chronic illness who have restrictions on their diet to try to see what will happen if they stray," said Dr. John Saltzman, Menino's gastroenterologist.

On Wednesday, the mayor was admitted to the hospital at about 6 p.m., and doctors discovered an intestinal blockage near the juncture of his small and large intestines. It was in the same 4-inch section that had become inflamed in an episode last March. Doctors said Menino's condition was improving yesterday, though he remained hospitalized last night.

''The mayor is getting a well-deserved and much-needed rest here at the hospital," Menino's physician, Dr. JudyAnn Bigby, said at the press conference.

Sometimes Crohn's blockages must be surgically removed, but Saltzman said he expects this blockage will respond to medication. The mayor could be released today, and doctors said he will be able to resume a full schedule at City Hall soon.

The doctors would not say when they gave Menino the diagnosis, but indicated he has known about his condition for months and has even been prescribed a Crohn's-specific diet.

Saltzman said it sometimes takes a while for patients to accept a diagnosis of Crohn's disease, which can cause painful and debilitating blockages of the small intestine due to inflammation.

''It's a process; it takes time," Saltzman said. ''We have been trying to interepret it with him for some time."

On March 30, upon leaving the hospital after an episode of inflammation, the mayor said Crohn's disease was not among the possible diagnoses his doctors were exploring. ''It's a lot of possibilities, but that's not one of the possibilities at this time," Menino told a reporter who asked whether he had Crohn's.

Menino has not talked publicly about the condition since.

''The mayor is a public figure, and he's entitled to as much privacy regarding his health matters as is appropriate to his condition," Bigby said.

Menino said last year that he has grown skittish about revealing health problems to the public because some press accounts overstep the boundary of what he feels should be made public.

At times, he has used the media to publicize his health problems, embarking on a public service advertising campaign about cancer-screening last year after having a small cancerous growth removed from his back.

The mayor was unavailable for comment last night, and his press secretary, Seth Gitell, referred questions to the doctors.

Menino has been hospitalized at least six times since he took office, three times for intestinal inflammation. In 1995 he was admitted for severe abdominal pain, though no cause was determined. In addition to his cancer surgery last year, he was treated for kidney stones in 1995 and again in 1997.

This has been a hectic year for Menino, who sometimes worked 18-hour days in the leadup to the Democratic National Convention. He hasn't taken a vacation this year, and some of his staff members said he has seemed to tire more easily in recent weeks.

Despite the diagnosis, his doctors insist he can still lead a robust life and carry out all the demands of his office.

Menino also has lost a significant amount of weight in recent months, dropping 10 percent of his body weight since last year.

Doctors would not disclose the mayor's exact weight and said Crohn's did not trigger his weight loss.

''He's been dieting for a while, completely motivated by the knowledge that he should weigh less," Bigby said.